三维增强磁共振血管造影在主动脉缩窄诊治中的应用

目的评价三维增强磁共振血管造影（3D CE-MRA）在主动脉缩窄诊治中的临床价值。方法21例主动脉缩窄病人用屏气超快速三维梯度回波序列行3D CE-MRA检查，工作站上三维重建。6例同期行心血管数字减影血管造影（DSA）检查。所有病例均经手术证实。结果21例中单纯主动脉缩窄6例，伴其他心血管畸形或病变15例。3D CE-MRA所显示的主动脉缩窄部位、程度及长度与手术所见一致，并能准确显示心外大血管病变，也易于进行手术前后评价。结论3D CE-MRA能无创、准确诊断主动脉缩窄。对主动脉缩窄整体全貌及侧支血管的显示，有助于临床手术方案的制定。对主动脉缩窄心外大血管病变的诊断可基本取代心血管DSA检查，可作为主动脉缩窄的首选检查方法之一。

Application of three-dimensional contrast-enhanced MR angiography in the diagnosis and treatment of aortic coarctation

Objective To evaluate the clinical value of three-dimensional contrast-enhanced MR angiography (3D CE-MRA) in the diagnosis and treatment of aortic coarctation. Methods Twenty-one patients with aortic coarctation underwent 3D CE-MRA with a 3D FLASH sequence after injection of 0.2 mmol Gd-DTPA per kg b. w. The source images were subtracted and transferred to computer workstation subsequently post-procession. In six patients, cardioangiography was performed simultaneously. The diagnoses of all patients of them were proven by surgery. Results There were 6 cases (28.6%) of simple type of aortic coarctation and 15 (71.4%) accompanied other cardiovascular abnormalities. 3D CE-MRA could directly demonstrate the stenotic location, degree, extent and extracardiac vascular abnormalities, which accorded with surgical findings. The depiction of the entirety and collateral vessel formation was very helpful for surgery. It can be easier for pre- and post- operative evaluation. Conclusion 3D CE-MRA is a noninvasive and accurate technique in the diagnosis of aortic coarctation. It could replace the cardioangiography for extracardiac vascular abnormalities, and may be one of the first choice examinations.